Brand New Day Program from Brand New Day

(a Medicare Advantage Special Needs Plan for persons disabled by chronic mental illness)

Pharmacy Quality Dispensing Bonus Program

In an effort to improve medication compliance for Brand New Day (BND) members with Poly Pharmacy, HMO California is putting in to place a program to encourage its pharmacy providers to furnish poly pharmacy members their medications in bubble packs and have the medication delivered to the member’s residence.

Incentive

For all Brand New Day members with poly pharmacy, pharmacies will be paid $3.25 per medication up to $32.50 per member per month up to a maximum of $195.00 per patient per year, when prescription(s) are provided in a single dose bubble packaging and delivered to the member’s residence or to another acceptable (approved) location such as the BND Wellness Center who can oversee medication compliance with the member.

Please use form below:

Pharmacy Name:
Pharcacy Tax ID:
Pharmacy Street Address:
City:
State:	Zip:
Pharmacy Fax No.:	E-mail:
Member's Name:
Member Date of Birth:
Member ID:
Date of Fill:
Medications were provided in bubble package and delivered to members residence:	YesNo
Number of medications filled: